面神经瘤的诊断与治疗

Diagnosis and Treatment of Facial Neuroma

目的探讨面神经瘤的临床表现、早期诊断和治疗,为面神经瘤的早期诊断和治疗提供临床经验。方法采用回顾性方法,对6例面神经瘤的诊断和治疗过程进行分析。面神经瘤的手术入路为,颅中窝—乳突径路1例,乳突径路4例,乳突腮腺联合径路1例。3例面神经瘤切除后同期进行耳大神经移植。结果面神经瘤完全切除6例,术后随访一年,6例均无复发,病理检查面神经鞘膜瘤5例,面神经纤维瘤1例。面神经功能恢复House-Brackmann评级:Ⅱ级1例,Ⅲ级2例,Ⅳ级2例,Ⅵ级1例。结论虽然面神经瘤的发生率低,但是只要了解其临床特点,加以重视并借助影像学手段,可以早期诊断,早期治疗,提高疗效。对于面神经瘤的治疗根据不同情况可考虑不同径路摘除肿瘤并行面神经重建手术。

Objective To explore the clinical manifestations, early diagnosis and treatment of facial neuroma and pro？vide clinical experience for early diagnosis and treatment of facial neuroma. Methods Analyze 6 cases of facial neuroma diag？nosis and treatment process with retrospective method. The operative approaches to facial neuroma include, 1 case of middle cranial fossa-mastoid approach, four cases of mastoid approach, and 1 case of mastoid parotid gland joint approach. Over fa？cial neuroma resection, nervus auricularis magnus transplant was performed on 3 cases. Result for 6 cases with facial neuro？ma resection, no relapse occurred after one year of follow-up visit, 5 cases of facial nerve schwannoma and 1 case of facial neurofibroma by pathological examination. Facial nerve functional recovery House-Brackmann ratings：1 case of levelⅡ, 2 cases of levelⅢ, 2 cases of levelⅣ, and 1 case of levelⅥ. Conclusion Although the incidence of facial nerve tumor is low, as long as we understand the clinical characteristics, value it and with the aid of imaging technologies, we can conduct early diagnosis, early treatment, and improve curative effect. According to the different situation in the treatment of facial neuroma, different path can be considered to remove tumor with facial nerve reconstruction.